common post natal problems

Question 1

skin colour problems

Answer 1

jaundice
pallor
plethora
cyanosis

Question 2

birthmarks

Answer 2

capillary hemangioma 
mongolian blue spot
port wine stain 
stork marks 
cafe au lait spots
giant melanocytic naevii

Question 3

plethora

Answer 3

redness

vascular problems
polycythemia

Question 4

cyanosis

Answer 4

peripheral: common, part of transition
central: needs Ix, O2 sats

Question 5

jaundice causes: 1st 24hrs

Answer 5

sepsis

haemolytic

Question 6

jaundice causes: 2nd day -2/3rd week

Answer 6

physiological
breast milk
sepsis
haemolysis

Question 7

jaundice causes: prolonges

Answer 7

breast milk
hypothyroid
biliary obsruction - biliary atresia

Question 8

Mx jaundice

Answer 8

treat underlying cause
hydrate 
phototherapy 
exchange transfusion 
Ig

Question 9

erythema toxicum

Answer 9

maculopapular rash
fades by end 1st week - no Rx needed

more common in term neonates - rare in preterm

Question 10

mongolian bluespots

Answer 10

blue-grey pigmented areas
accumulation of melanocytes

often lower back and buttocks
commoner in races with pigmented skin

Question 11

capillary vascular malformations

Answer 11

stork marks

port wine stain

Question 12

stork marks

Answer 12

naevus simplex
light colour capillary dilatation, commonly back of neck. + midline of face
within 1st 2yrs life, gradually fades

Question 13

port wine stain

Answer 13

naevus flammeus
present at birth: flat or slightly raised
caused by dilatation of mature capillaries in superficial dermis
doesn’t regress

Question 14

port wine stain associations

Answer 14

klippel trenuany

sturge-weber syndrome

Question 15

capillary heamangioma - strawberry naevus

Answer 15

cluster of dilated capillaries, appearing within 1st mo
raised and bright red, discrete edges, occuring anywhere on body
usually regress >1yoa

Question 16

what happens to neonate in cold stress

Answer 16

reduced arteriolar oxygen
metabolic acidosis
hypoglycaemia
reduced surfactant production

Question 17

management to prevent neonate hypothermia

Answer 17

dry quickly
remove wet linens
use warm towels
heated/humidified oxygen

Question 18

hypoglycaemia

Answer 18

blood sugar <2mmol /l

Question 19

hypoglycaemia: babies at risk

Answer 19

limited Glc supply: premature, perinatal stress
hyperinsulinism: diabetic mum
inc Glc use: sepsis, hypothermia

Question 20

hypoglycaemia when can bedside tests be inaccurate

Answer 20

high or low levels
poor perfusion
polycythemia

Question 21

hypoglycaemia best detection methods

Answer 21

blood gas machine

lab testing

Question 22

hypoglycaemia features

Answer 22

jitteriness
lethargy 
temp instability 
apnoea
hypotonia 
poor suck/feeding
high pitched cry 
seizures

Question 23

tongue ties

Answer 23

short +/- thickened frenulum

attatched anteriorly - base of tongue

Question 24

tongue tie management

Answer 24

most need none

frenotomy: if restriction tongue protrusion beyond alveolar margins and feeding is affected

Question 25

evaluation of resp distress

Answer 25

resp rate: newborn tachypnoea >60/min
O2 sats
colour
inc work breathing: grunting, nasal flaring, retraction

Question 26

what can absent/weak femoral pulses be a sign of

Answer 26

coarctation of aorta

Question 27

cleft lip classifications

Answer 27

incomplete or complete (continues to nose)

unilateral or bilateral

Question 28

cleft lip

Answer 28

maxillary and medial nasal proscesses fail to merge, usually ~5wks gestation

Question 29

cleft lip issues

Answer 29

feeding problems
airway problems
assoc anomalies: hearing screen, ECHO

Question 30

cataracts

Answer 30

lens opacification
can lead to blindness if undetected

Mx: nothing or lens removal and artificial lens

Question 31

retinoblastoma

Answer 31

rare eye cancer
treated successfully if early detection

Rx: chemo, laster therapy, eye removal

Question 32

pseudomenstruation

Answer 32

girls vaginal bleed 2-10days
sudden lack of oestrogen supply from mum

usually lasts ~2 days, harmless

Question 33

spinal dimples

Answer 33

can reveal more serious abnormality involving spine +/- spinal cord e.g. spina bifida

Question 34

spinal dimples: when to do no further investigations

Answer 34

small, close to anus, in midline, no assoc skin features

Question 35

spinal dimples: when to do spinal USS

Answer 35

large, off midline, further away from anus and assoc cutaenous marker e.g. hair growth

Question 36

cephaloheamatomas

Answer 36

localised swelling over 1 or both sides head
maximised by day 3/4life

soft, non-transculemt
beneath pericranium

Question 37

cephaloheamatomas Rx

Answer 37

no rx neeed, resolution within 3-4wks

Question 38

DDH

Answer 38

socket is shallow and not developed properly to hip has tendency to slip out and become dislocated

Question 39

trisomy 21 features

Answer 39

low set ears
epicanthic fold 
single palmar creases
cardiac defects
learning problems 
thyroid problems